目的:分析老年冠心病患者危险因素及预后的危险因素.方法:回顾性分析于我院疑诊为冠心病的412例老年患者的临床资料,根据冠脉造影结果分为冠心病组(283例)和非冠心病组(129例);分析老年冠心病患者危险因素及预后相关危险因素.结果:与非冠心病组比较,冠心病组80岁以上(13.95%比28.98%)、 糖尿病(37.98%比66.78%)、有吸烟史(32.56%比59.72%)者比例、总胆固醇[TC,(5.06±1.53)mmol/L比(5.41±1.36)mmol/L]、甘油三酯[TG,(1.53±0.82)mmol/L比(2.02±0.95)mmol/L]、低密度脂蛋白-胆固醇[LDL-C,(2.05±0.86)mmol/L比(2.57±1.15)mmol/L]水平明显升高,高密度脂蛋白-胆固醇[HDL-C,(1.65±0.52)mmol/L比(0.86±0.38)mmol/L]明显降低(P<0.05或<0.01).多因素Logistic回归分析结果显示:年龄、糖尿病、高血压病史、吸烟、高TC、高TG是冠心病的独立危险因素(OR=1.38~8.65,P<0.05或<0.01);而HDL-C是冠心病的独立保护因素(OR=0.224,P=0.002);采用多因素Cox模型分析显示吸烟史、高总胆固醇和高血压为影响冠心病患者预后的危险因素(RR=1.563~2.315,P均<0.05).结论:在临床工作中,应力求减少或消除老年冠心病患者的相关危险因素,改善预后.%Objective:To analyze risk factors and prognostic risk factors in aged patients with coronary heart disease (CHD).Methods:Clinical data of 412 aged patients,who were suspected of CHD in our hospital,were retrospec-tively analyzed.According to results of coronary angiography,they were divided into CHD group (n=283 )and non-CHD group (n=129);risk factors and prognostic risk factors for aged CHD patients were analyzed.Results:Compared with non-CHD group,there were significant rise in percentages of >80 years (13.95% vs.28.98%),di-abetes mellitus (DM,37.98% vs.66.78%)and smoking history (32.56% vs.59.72%)in CHD group,levels of to-tal cholesterol [TC,(5.06±1.53)mmol/L vs.(5.41±1.36)mmol/L],triglyceride [TG,(1.53±0.82)mmol/L vs.(2.02±0.95)mmol/L]and low density lipoprotein cholesterol [LDL-C,(2.05±0.86)mmol/L vs.(2.57 ±1.15)mmol/L],and significant reduction in high density lipoprotein cholesterol level [HDL-C, (1.65 ±0.52) mmol/L vs.(0.86±0.38)mmol/L]in CHD group,P <0.05 or <0.01. Multi-factor Logistic regression analysis indicated that age,DM,hypertension history,smoking,high total cholesterol (TC)and hypertriglyceridemia were independent risk factors for CHD (OR= 1.38 ~8.65,P <0.05 or <0.01 );while serum total bilirubin and high density lipoprotein cholesterol were independent protective factors for CHD (OR=0.224,P =0.002);multi-factor Cox model analysis indicated that smoking history,high TC and hypertension were risk factors affecting prognosis of CHD patients (RR= 1.563 ~ 2.315,P < 0.05 all).Conclusion:In clinic,attention should be paid to reduce or eliminaterelated risk factors of aged CHD patients to improve prognosis.
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